How to get the Covid-19 jab, with or without medical aid

The Department of Health on Wednesday said the Covid-19 vaccine has been declared a “public good”, which means the government will provide funding for the almost 33 million citizens who don’t have private health insurance.

Health Minister Dr Zweli Mkhize confirmed that the first batch of 1 million doses of the Oxford-AstraZeneca vaccine from the Serum Institute of India (SII) will depart from India on Sunday and arrive at OR Tambo International Airport via Dubai on Monday.

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However, Mkhize said it would take 10 to 14 days for various processes to be done before the vaccines will be ready to be distributed to all provinces.

The minister was speaking during a webinar where he was joined by several health professionals from his department who explained the first phase of South Africa’s Covid-19 vaccination programme, which will prioritise healthcare workers.

According to Dr Aquina Thulare, a technical adviser from the health department, the vaccines have been declared a “public good”.

Below is a summary of how the vaccines will be funded:

If you have medical aid

• Funding for the vaccine will come from medical schemes.
• The vaccine will be administered free at the point of service.

• Private providers (including pharmacies) will procure the vaccine from the Central Distributor from government through their wholesalers at the “single exit price” (SEP), which is lists the maximum price a medicine can be charged at.

• Private providers like pharmacies will bill the medical scheme for the cost of the vaccine as well as the administration and will be paid as a prescribed minimum benefit (PMB). The PMB means medical aid schemes will be obliged to pay for this service and are expected to pay directly to those that are providing vaccination services, whether it is hospitals, community pharmacies, and general practitioners.

• In the case of insured healthcare workers vaccinated in public health facilities, the vaccine will be supplied to the health facility as a designated service provider (DSPs) by medical schemes, and the facility will bill the medical scheme for reimbursement of the vaccination.

• The Electronic Vaccine Data System (EVDS) will be used to plan, execute and monitor vaccination of insured health care workers.

If you don’t have medical aid

• The public sector, government, will be the preferred provider for citizens who don’t belong to a medical scheme. And the vaccination will be free at the point of service

• As vaccination is a public good, government will provide funding for the uninsured population.
• Uninsured health workers will be funded by government and where there is willingness by employers in the private sector in line with principles of social solidarity to achieve herd immunity, also known as population immunity.

• Vaccines will be received from the Central Distributer, which is government.

• Provincial health departments will not be required to pay for the vaccine from the Central Distributor.

• Where there is a need to augment the public sector capacity, government will contract private providers based on their location, capacity and other relevant considerations. These will include private pharmacies, GP’s and other providers in line with their scope of practice.
• Uninsured citizens who want to access vaccination services whether through public facilities or accredited private provider, will follow the use of the Electronic Vaccine Data System (EVDS) for pre-booking and recording of the vaccination. A contract with the accredited private provider will include a vaccination administration fee set between R50 and R60 per patient inclusive of VAT, which government will reimburse the private provider.

• A patient’s ID number will also linked to the health patient registration system (HPRS), which will be used for identification and billing.

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